Natural family planning

Benefits

*As long as your menstrual cycle is regular (this means that it may not be suitable if you have recently started having periods or if you are close to the menopause).

A means of monitoring your monthly fertility cycle to plan for or avoid pregnancy.

Natural family planning, or fertility awareness is when you learn to identify small physical changes that tell you when you are entering your fertile period each month - the days when you could become pregnant if you have unprotected sex.

Using natural family planning means that you need to measure these changes carefully at the same time every day and abstain from sex or use condoms at the time when you are fertile.

Women may choose to record their fertility information on a chart or use an app.

Natural family planning is not suitable for women with very irregular cycles, women who might find it difficult to record their temperature every day before getting up and women whose daily schedules are disrupted by shift work or frequent travel.

It may be used by women who prefer not to use hormone-based contraception.

Natural family planning does not prevent sexually transmitted infections (STIs). Condoms are the only effective method of protection against STIs.

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How it works

How it works

Natural family planning works because the levels of certain hormones in your body change throughout your menstrual cycle, causing small physical changes as you reach your most fertile period. These changes are called your ‘fertility indicators’. The most reliable indicators are:

thickening the mucus in the neck of the womb, so it is harder for sperm to penetrate the womb and reach an egg

the amount and consistency of your cervical secretions

your body temperature on waking

the length of your menstrual cycle.

By monitoring and recording these indicators, you will get to know when your fertile days are each month.

How to use it

You’ll need to monitor changes to your body every day – this means keeping a daily record of your waking or ‘basal’ body temperature, as well as changes to your cervical secretions. You will get to expect these changes as you get used to using this method, but if you are not good at keeping records, then this may not be the most effective method of contraception for you.

Once you’ve recorded these indicators, you need to analyse them to work when you are likely to be fertile.

The Family Planning Association offers comprehensive guidance on the natural family planning method at Sexwise.

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Learning to read your fertility indicators

As you spend more time using this method, you’ll get to know how your fertility indicators change as you are approaching, during, and after your fertile days.

Cervical secretions: the fluid that you can feel in your vagina will feel more dry just after your period; moist, sticky or creamy as you approach your fertile time; and clear and stretchy (like raw egg white) just before ovulation. After ovulation the secretions revert to being thick and sticky again.

Your body temperature: hormonal changes also make your body temperature rise slightly during the second phase of your menstrual cycle, after ovulation. The fertile time ends when you've had three consecutive days of higher temperatures, which are higher than all of the previous six days. It is important that you take your temperature first thing in the morning, before you get out of bed, or after you have been resting for at least 3 hours - this is known as your basal or waking body temperature.

Your menstrual cycle: if you have a regular cycle, take your shortest cycle length over the last 12 months, then subtract 20 days to find the first fertile day.

Once you start to look out for these changes, it can become very obvious when you are at your most fertile.

You’ll need to use two or more indicators for effective use of the natural family planning method. Using one indicator alone, for example, counting the days in your menstrual cycle, is not accurate enough to monitor your fertile period, so is not reliable as a method of contraception.

Things to consider

Your fertile time lasts for around 8 - 9 days of each menstrual cycle. Ovulation (when an egg is released from your ovaries) lasts for 12 - 48 hours, however, sperm can live inside a woman's body for up to seven days. This means that if you have sex as much as seven days before ovulation you may get pregnant. Fertility awareness is not just about tracking the 2 - 3 most fertile days, but being aware of the full fertile phase.

You’ll need a good quality, digital centigrade thermometer, and need to remember to take your temperature every day before you get out of bed, and before you eat or drink anything. Small amounts of physical activity, as well as bathing, stress, ill health or drinking alcohol could change your temperature enough to make it an inaccurate indicator of fertility. Your temperature will only rise by about 0.2 degrees centigrade during the second phase of your menstrual cycle so your measurements need to be as accurate as possible.

Suitability

Natural family planning is not a suitable method of contraception for women with irregular periods.

This method is suited to women who are confident that they can control when they have sex or negotiate effective condom use during their 8 - 9 fertile days.

Users of this method must also be able to reliably take their temperature every day before getting out of bed, it is important to be aware that things like travel or viral illnesses can disrupt the measurements and cause incorrect readings.

It can be harder for women to monitor their fertility indicators during times of major hormonal change, for example if they have recently had a baby, stopped breastfeeding, had a miscarriage, stopped another form of hormonal contraception or are experiencing menopause. During this period and for up 6 months afterwards, using another form of contraception, such as condoms is recommended.

Side effects & risks

As with all methods of contraception, there is a risk of pregnancy if the method is not used properly.

However, many women enjoy natural family planning as it has no side effects and can help you to get to know and understand your body and your menstrual cycle.

According to the Family Planning Association, 'your fertile time starts at the first sign of cervical secretions and ends after the third high basal temperature has been recorded and all three high temperatures occur after the last day of having wet or clear, slippery secretions (the peak day)'.

Natural family planning apps

There various apps which allow you to quickly and easily record and track physical and emotional changes. These apps use different methods of tracking your fertility – so make sure you do your research before choosing one that is right for you and your situation.

Many of these apps are free but may charge for additional services, for example, a specialist thermometer that can relay your basal body temperature directly to the app.

Fertility or contraception monitors

These are physical devices which measure the amount of the hormones estrogen and progesterone in your urine. These are available to buy in most high street pharmacies, but can be quite expensive as a regular method of contraception.

Evidence on the effectiveness of the natural family planning method is limited. It dependends how many different indicators of fertility you monitor. The use of one indicator alone is associated with a 24% failure rate within one year, but the use of three indicators (e.g. day of menstrual cycle, nature of cervical secretions and body temperature) reduces the failure rate to 0.4%.